Moving the Resident from a Bed to a Stretcher or Gurney

Written by Hollie Finders, RN
Hollie Finders is a registered nurse with years of experience working in the health care field. She has degrees in both biochemistry and nursing. After working with patients of all ages, Hollie now specializes in pediatric intensive care nursing. Hollie’s LinkedIn

Procedure

Equipment needed: 2-3 coworkers, bath blanket, stretcher or gurney

Perform hand hygiene.
Explain the procedure to the patient and ask for his or her assistance in following directions.
Lock the bed wheels and raise the bed to a comfortable working height.
Lower the head of the bed until flat. Lower the side rail on the working side.
Cover the patient with a bath blanket and remove the patient’s top sheets.
Loosen the bottom sheet from underneath the patient. Roll the bottom sheet towards the patient.
Align the stretcher next to the patient’s bed. Ensure the side rails are down, the wheels are locked, and that the height of the stretcher matches that of the bed.
Have a coworker or two lower the side rail on the other side of the bed, loosen the bottom sheet, and roll it towards the patient.
Instruct the patient to cross his or her arms across the chest. Ensure the patient is ready for the transfer and inform the patient when it will happen.
With a coworker joining you on your side, reach over the stretcher and grab the roll of sheets. Have the coworkers on the other side of the bed grab the roll of sheets on their side.
On the count of three, have everyone gently lift and slide the patient onto the stretcher. Use proper body mechanics to avoid injury.
Raise the side rails on the stretcher.
Unlock the stretcher’s wheels and transport the patient to the desired destination with the assistance of another coworker. Do not leave the patient alone in the stretcher.

Important Information

Moving a patient from a bed to a stretcher can pose huge safety risks to both the patient and to the health care workers completing the transfer. Always use the appropriate amount of people to complete a transfer, which may vary according to the patient’s weight and/or the facility’s policy. In some cases, a mechanical lift may be needed [1]. Before moving the patient, always ensure that the transfer can occur in one fluid motion. For instance, make certain that there is enough slack on a patient’s oxygen tubing or IV lines to avoid injuring the patient or damaging the equipment.

References

Guidelines for Nursing Homes

More Resources

Assisting the Resident to Transfer from the Bed to a Chair or Wheelchair

It is important to remember on which side to place the chair when assisting a patient in transferring. Putting the chair on the resident’s unaffected side allows the resident to lead with his or her strong extremity. This eases the procedure for the resident and reduces the risk of falling.

Indwelling Catheter Care

Indwelling catheters allow urine to drain from the bladder. They are used when residents are unable to urinate on their own or when the process of cleaning the resident after urination would be difficult for the resident to tolerate (such as during end of life care). Caring for the catheter appropriately is a vital part of preventing infection and skin breakdown.

Sim’s Position

The position a patient is placed in is often ordered by the physician, or recommended by a speech, occupational, or physical therapist. The position dictates whether a patient is sitting, lying, standing; or if they are on their side, back, or prone (face-down). Positioning is also determined by the patient’s current needs, such as: Are they eating? Sleeping? Having surgery on their back? Are they receiving nutrition through a nasogastric tube?

Assisting the Resident to Sit on the Side of the Bed

Having the resident sit on the side of the bed is otherwise referred to as dangling. When a resident quickly changes position, especially from lying to sitting or standing, there can be a rapid drop in the resident’s blood pressure. This drop in blood pressure may cause dizziness or lightheadedness.

Measuring the Apical Pulse

The apical pulse rate is the most accurate non-invasive measurement of heart rate because it is measured directly over the apex of the heart. Apical pulse is preferred in cases when the radial pulse is difficult to palpate, when the pulse is irregular, greater than 100 beats per minute, or less than 60 beats per minute when measured by other means (electronic, radial, etc.).

Offering the Bedpan

When a resident is bed-bound, they must use a bedpan to urinate and defecate. This can be embarrassing for the resident, so it should be done with sensitivity to the resident’s privacy and dignity. There are two types of bedpans. A regular bedpan is the deeper and more rounded of the two. A fracture pan has a relatively flat upper end with a trough at the lower end. Fracture pans are used for residents who have difficulty, or restrictions against, moving their hips and/or backs.